7 Foundations of Sustainable Weight Loss

If you’re reading this I think it’s safe to assume you are interested in health and well-being. And if you’re interested in health and well-being, I think it’s safe to assume that you have wanted to lose weight at some point if not right now. Diets, exercise programs, and the failures wrapped up in it all can be daunting. Lots of information about weight loss is conflicting and might leave more questions than answers.

Is the only way to lose weight eating less?

Do I have to track my food to lose weight?

Can I lose weight while eating carbs?

Can I eat whatever I want as long as it fits within my daily calorie goal?

Why is it not working even though I’m doing everything “right?”

So today I’m going to touch on what has been the resounding, but still controversial, concept at the base of weight loss: calories in vs. calories out. Many folks are suggesting it’s a myth and that you can eat in a surplus and still lose weight. Others argue that you can theoretically eat nothing but Pop-Tarts so long as it “fits your macros” or stays within your daily caloric limit. I’d like to break down what that concept means and how far it reaches. Hopefully some of the factors I’ll discuss resonate with you.

To start, let me clear the air: you do need to eat less calories (the calories in portion) than you burn (the calories out portion). This is basic thermodynamics. What’s missing from our equation though is just how complex calorie expenditure really is. There’s more to “calories out” than what the treadmill screen says.

Individual caloric expenditure is mostly determined by a person’s basal metabolic rate or BMR. BMR is basically the amount of energy your body uses on a daily basis to fuel your basic functions like your heart pumping, your brain neurons firing, and your lungs breathing, even if you didn’t move at all. This is what any calorie tracker estimates when calculating your requirements to lose weight. It gives a rough estimate based on age, sex, and general activity level. So there are three basic factors at play here: the calories you eat, BMR, and calories burned from physical activity.

Now consider what you can adjust. The conversation about weight loss usually only focuses on two — calories you eat and those burned with physical activity. This leads to an over-reliance on eating less, moving more. Now that’s not inherently bad, but it leaves you very few options once your body adapts to fewer calories from food and higher amounts of exercise. Restriction and excessive exercise might shed the pounds for a short period of time but you don’t want to end up having to take that to extremes. Before you know it you’re hungry all the time, cranky, tired, and not getting the results you wanted in the first place. Bodies are adaptation machines and you can only take diet and exercise so far.

For most people, tipping the calorie balance in the favor of weight loss can have health benefits but your body gets SCARED when that happens. So it conserves energy by ramping down your BMR. That is not what you want in the long-term. The good news is, you can affect your BMR too! Your metabolism adjusts in response to signals from all your body’s other systems. When you put those systems in a state of good health, those benefits generally translate to the scale in a healthy way. Let’s talk about some of those systems and the effect they have on your BMR.


I’m making this number one for a reason! Mental, emotional, and physical stress all result in the same physiologic response in the body and that’s cortisol production. Cortisol is the feel-good steroid hormone produced by the adrenal glands that keeps things running in high-stress situations, so we have the energy to (ideally) address and eliminate that stress. Cortisol has a myriad of effects on the body long-term which are discussed at length here, including several related to metabolism.

  • Raises blood sugar

  • Increases breakdown of muscle

  • Increases hunger

  • Disrupts sleep

  • Suppresses hormonal feedback

  • Disrupts gut bacteria

Muscle Mass

This one is pretty simple but pretty high up on the priority list for long-term weight maintenance. Muscle is a very demanding tissue to carry around because it is highly vascular (has lots of blood vessels). This requires a lot of energy in the form of calories to keep it healthy. Having lean muscle mass can help you burn body fat even when you’re not actively moving (BMR!). Strength training is often a big missing piece of the puzzle for folks who struggle with healthy weight.


More than 1/3 of Americans don’t get enough sleep (at least 7 hours). As our environments become more stimulating with social media, radiation exposure, toxins, and sugar, good sleep is more important than ever. These things also make it harder to get. Lack of sleep has detrimental effects on metabolism.

  • Increase cortisol production (see above)

  • Makes you crave sugar

  • Less energy to exercise

  • Decrease ability for healthy decision-making

  • Leads to insulin resistance


Healthy hormone balance is crucial for supporting metabolism. Hormones have unique effects on where and how much fat is stored, as well as how difficult it is to shed. The synergism between hormones is complex but their failings are commonly seen in mid-life to older age, starting/stopping birth control, and puberty. Hormonal regulation is influenced by blood sugar, the ability of the liver to detoxify, and stress – all things that are discussed in this article. Hormonal health also includes the thyroid. Thyroid hormone has a huge effect on metabolism, and unfortunately not having enough of it is a reality for many women. If you have a thyroid condition, work with a practitioner and a doctor to address the root cause.

Gut Health

More and more research continues to surface about the ways in which the bugs in our guts control our health. Bacteria in your intestines take what they want from your food in the final step of digestion. None of these bacteria are inherently bad, but when some types start to outgrow others, it can be bad for us. This condition is called dysbiosis. Dysbiosis can actually make us crave certain foods. Since most of these bacteria feed on carbohydrates they can literally tell our brains to seek out sugary foods. Of course, this isn’t good for blood sugar regulation or maintaining a healthy diet.

Blood Sugar Regulation

Your body’s ability to regulate blood sugar has a massive effect on metabolism. Constant insulin spikes brought on by eating sugar and refined carbohydrates tell our bodies to burn less fat and store more. Over a long period of time this pattern can lead to insulin resistance and Type II Diabetes.

Liver Health

The liver has hundreds of functions, many of which are yet to be understood. It is largely known for being the detoxifying organ which makes it important for weight loss. Exposure to environmental toxins, hormonal birth control, and medications strain the liver by forcing it to work overtime. When the liver doesn’t have the nutrients, hydration, and support it needs to detoxify these agents, they are left in excess. Hormones that are waiting to be broken down can continue circulating and cause weight gain. Another major role of the liver is the production, storage, and breakdown of muscle, fat and protein. Those reactions are all influenced by blood sugar handling.


There are clearly a lot of factors to consider supporting in an endeavor to lose weight. Instead of being overwhelmed, I challenge you to think about the fact that you can work on any or all of these variables before deciding to dramatically reduce your food intake. Folks telling you to eat less and move more are not disclosing the fact that you will eventually hit a wall with that strategy. Supporting these normal functions will keep you healthier overall and improve your ability to maintain a healthy weight long-term. In general, my corresponding recommendations are as follows.

Action Items

  1. Focus on stress reduction. Work on finding the things about your average day that you can make easier (meal prep, develop a routine, delegate some tasks, etc.) Implement a mindfulness practice like daily walks, meditation, or prayer.

  2. Start strength training. Work on increasing your muscle mass to raise your BMR. I recommend getting a referral to a personal trainer who can help you if you are new to strength training.

  3. Sleep more. Aim for 8 hours per night and work on sleep hygiene. Go to bed and wake up at roughly the same time each day. Don’t watch TV two hours before bed. Also try to avoid your phone during that time. Don’t drink caffeine late in the day. Sleep in a dark room.

  4. Support hormonal balance. Avoid refined carbohydrates and unhealthy fats. Talk to your doctor about options other than hormonal birth control if that is something you currently use. Ensure you are following recommendations 1 & 2 😊

  5. Support a healthy gut. Again, work on the above recommendations. Ask your pharmacist for a good probiotic recommendation. Avoid sugars and any foods that cause digestive stress for you. Work with a practitioner who can help you heal gut dysbiosis.

  6. Promote healthy sugar handling. Eat a diet rich in healthy fats, protein, vegetables, and whole food carbohydrates (properly-prepared grains, fruit, potatoes).

  7. Support your liver. Drink plenty of water and consider a multivitamin that contains nutrients the liver needs (talk to me for a recommendation!). Make an effort to reduce exposure to environmental toxins from cleaning supplies, cosmetics, and processed foods. If you can, consider removing synthetic hormones from your contraceptive plan. Bonus points: work a bit of beef or chicken liver into your diet every week!

In summary, a healthy approach to weight loss includes much more than the miserable endeavor of reducing your food intake and running miles every day. Use this multi-factorial approach for healthful, sustainable weight management. Visit the Services page or contact me if you are interested in working one-on-one on weight loss or any of the tasks listed above.

Be well,